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General NPI Number Information
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NPI Number | 1396046835
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Entity Type | Organization
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Legal Business Name | A TO Z FAMILY SERVICES, INC.
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 44 N MAIN
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City | MALAD
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State | ID
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Zip | 83252
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Country | US
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Telephone | 208-766-2389
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Fax | 208-766-2385
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Provider Business Mailing Address
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Address Line | 44 N MAIN ST
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City | MALAD CITY
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State | ID
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Zip | 83252-1200
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Country | US
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Telephone | 208-766-2389
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Fax | 208-766-2385
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Authorized Official
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Title or Position | CEO
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Name | MR. REBECCA J PERRENOUD
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Credential | LCSW CIBI ACADC
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Telephone | 208-785-1326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | LMSW-30276
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License Number State | ID
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